Varicocele: Symptoms, Diagnosis, and Treatment Options

Varicocele

Hello Doctor, I recently visited a clinic because I felt discomfort in my left testicle.
The clinic only asked me to take off my pants for a quick examination and then said I have a problem with varicocele.
They hastily prescribed medication without answering my questions, so I am seeking help here.
My left testicle is visibly swollen, and there seems to be a significant size difference between the two testicles.
I am concerned whether this will affect my fertility and if surgical treatment is necessary.
Can a general clinic perform a detailed examination, and what tests are typically conducted? Despite taking medication for the past few days, my testicle still hurts.
I wanted to gather your opinion before seeking further medical advice.
Also, could you recommend a good physician in Kaohsiung?

Mi Huo Xue Sheng, 20~29 year old female. Ask Date: 2005/11/03

Dr. Xu Weikai reply Urology

Hello, varicocele requires surgical intervention or further examination under the following circumstances: 1.
Severe pain 2.
Impact on fertility 3.
Occurrence on the right side or bilaterally 4.
Elderly patients 5.
Suspected intra-abdominal lesions.
Generally, a diagnosis can often be made at a glance, which is not necessarily a failure on the part of the physician.
A small number of patients may require ultrasound for a definitive diagnosis.
In the Kaohsiung area, physicians can be found at hospitals such as Kaohsiung Veterans General Hospital, as the difficulty of this surgery is not high, and most urologists are competent to perform it.
Sincerely, Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2005/11/03

More Info

Varicocele is a condition characterized by the enlargement of the veins within the scrotum, similar to varicose veins that can occur in the legs. It is a common condition, particularly among young men, and can lead to various symptoms and complications, including discomfort, pain, and potential fertility issues.

Symptoms of Varicocele
The most common symptoms associated with varicocele include:
1. Pain or Discomfort: Many individuals report a dull ache or discomfort in the affected testicle, which may worsen with prolonged standing or physical activity.

2. Visible Swelling: The affected side of the scrotum may appear swollen or enlarged, often described as feeling like a "bag of worms."
3. Changes in Testicular Size: There may be a noticeable difference in size between the two testicles, with the affected testicle often being smaller due to impaired blood flow.

4. Fertility Issues: Varicoceles are associated with reduced fertility, as they can affect sperm production and quality.

Diagnosis
Diagnosis of varicocele typically involves:
1. Physical Examination: A healthcare provider will perform a physical examination, often while the patient is standing, to assess for the presence of enlarged veins.

2. Ultrasound: A scrotal ultrasound may be ordered to confirm the diagnosis and assess the severity of the varicocele. This imaging test can help visualize the blood flow and the size of the veins.

3. Semen Analysis: If fertility is a concern, a semen analysis may be performed to evaluate sperm count, motility, and morphology.

Treatment Options
Treatment for varicocele may not be necessary if there are no symptoms or fertility concerns. However, if symptoms are present or if there is a desire to improve fertility, treatment options include:
1. Observation: In cases where symptoms are mild and there are no fertility issues, a "watchful waiting" approach may be taken.

2. Medications: Pain relief can be managed with over-the-counter pain relievers, but these do not address the underlying issue.

3. Surgical Intervention: If varicocele causes significant discomfort or fertility problems, surgical options may be considered. The most common surgical procedures include:
- Varicocelectomy: This is a surgical procedure to remove the affected veins, which can improve symptoms and potentially enhance fertility.

- Embolization: A minimally invasive procedure where a catheter is used to block the affected veins, redirecting blood flow.

Impact on Fertility
Varicocele can negatively impact fertility by affecting sperm production and quality. Studies have shown that varicocele repair can lead to improved sperm parameters and increased chances of conception. If you are concerned about fertility, it is essential to discuss this with your healthcare provider.

Seeking Further Evaluation
If you are experiencing persistent pain or discomfort in your left testicle, it is advisable to seek a second opinion or further evaluation from a urologist, particularly one who specializes in male reproductive health. A general clinic may be able to perform initial assessments, but a specialist can provide more comprehensive care and treatment options.

Recommendations for Specialists
In Kaohsiung, you may want to consider visiting a reputable urology clinic or hospital. Look for specialists with experience in treating varicocele and male fertility issues. It is always beneficial to read reviews or ask for recommendations from other patients.

In conclusion, while varicocele is a common condition, it can have implications for your health and fertility. It is essential to have a thorough evaluation and discuss your concerns with a qualified healthcare provider to determine the best course of action for your situation.

Similar Q&A

Managing Varicocele: Symptoms, Treatment Options, and Relief Strategies

Hello Doctor, I have been experiencing varicocele for about two years. Recently, I had an examination, and the doctor stated that "surgery is not necessary," but on that day, the varicocele was less pronounced due to the cold weather. Normally, the left side shows a sig...

Dr. Du Shixi reply Urology
Hello: Please take care of your lifestyle and avoid excessive abdominal strain for prolonged periods, as neglecting this after surgery can increase the risk of recurrence. It is advisable to have regular follow-ups at a major hospital. Wishing you good health.

Understanding Varicocele: Symptoms, Diagnosis, and Treatment Options

I would like to ask the doctor, I was recently diagnosed with varicocele, and my scrotum appears to be uneven in size. I have a slight feeling of fullness in my lower abdomen, and I had a semen analysis done once, which showed a sperm count of approximately 6 million; this test w...

Dr. Fu Shizhang reply Urology
Varicocele is primarily diagnosed through visual inspection and palpation, with ultrasound serving as an auxiliary tool that is not always necessary. The main treatment approach for varicocele is surgical intervention.

Understanding Varicocele: Symptoms, Diagnosis, and Treatment Options

Hello doctor, I have been experiencing frequent testicular pain recently. After undergoing an ultrasound at the hospital, I was diagnosed with varicocele. The doctor prescribed medication for me, but I still occasionally experience sharp pain, and sometimes I also feel pain in my...

Dr. Du Shixi reply Urology
Hello: 1) Varicose veins often cause scrotal pain or discomfort near the groin area. 2) Ultrasound is sufficient for diagnosis. 3) Regarding surgery, it depends on the individual, but recurrence is common. It's important to discuss with your physician first to minimize the r...

Understanding Varicocele: Symptoms, Risks, and Treatment Options

During my enlistment medical examination, the examining doctor told me that I have a varicocele. I didn't have time to ask him, so could you please tell me what I should do, what potential complications or symptoms I might experience, and how it can be treated? Thank you!

Dr. Zhang Zhenxiang reply Surgery
Varicocele occurs in about 1 in 5 young males, often discovered during school or military entrance examinations, so there is no need for immediate concern. This condition primarily results from poor venous return in the internal spermatic vein, leading to blood pooling on the pos...